Avtor/Urednik		Marušič, Andrej; Marušič, Dorjan; Starc, Radovan
Naslov		Can psychological risk factors for coronary heart disease predict extent and severity of coronary atherosclerosis?
Prevedeni naslov		Ali lahko psihološki dejavniki tveganja za koronarno srčno bolezen napovedujejo razširjenost in težavnost koronarne ateroskleroze?
Tip		članek
Vir		Zdrav Vars
Vol. in št.		Letnik 42, št. 3
Leto izdaje		2003
Obseg		str. 95-101
Jezik		eng
Abstrakt		Objective: The main objective of the present study was to test prediction of angiographically determined coronary atherosclerosis on the basis of presence of various psychological and other coronary risk factors. Methods: The sample constituted 176 male patients with coronary heart disease (CHD) who underwent coronary angiography. Exploratory variables consisted of psychological (personality traits of neuroticism and sensitisation, and emotional coping style) and other coronary risk factors (age, family history, smoking, hypertension, total, LDL and HDL cholesterol). Outcome variables of the study were extent score of disease and severity score of disease. The goal of statistical analysis was to find best fitting multivariate linear models. Results: Both final models included only LDL and age. Psychological risk factors did not contribute significantly to the prediction of extent and seventy of coronary artery disease. Conduslon: We cbncluded that the clinical entity of CHD should be differentiated from its underlying pathologic process, coronary atherosclerosis; and so should be CHD risk factors distinguished from the risk factors for development of atherosclerosis. Different reasons can be given for the absence of significant associations between important risk factors and extent or severity of disease. For psychological risk factor in particular, a multistage development of CHD with the potential for different risk factors involvement at different stages, is the best explanation. Most probably, psychological risk facto are involved in acute and sudden deteriorations in coronary flow due to coronary vasoconstriction or spasm, which makes them mote important in the secondary rather than the primary prevention of coronary heart disease.
Izvleček		Namen: Osnovni namen predstavljene študije je bil preveriti, ali lahko napovemo angiografsko določeno koronarno aterosklerozo na podlagi podatkov o prisotnosti različnih psiholoških in drugih koronarnih dejavnikov tveganja. Metode dela: Vzorec je sestavljalo 176 bolnikov moškega spola s koronamo boleznijo (KB) po koronarni angiografiji. Obravnavane neodvisne spremenljivke so predstavljale psihološki (osebnostni potezi neuroticizma in senzitizacije ter emocionalno obvladovanje stresa) in drugi koronarni dejavniki tveganja (starost; pozitivna družinska anamneza, kajenje, povišan krvni tlak, celokupni, LDL in HDL hofesterol), Odvisni spremenljivki sta bila rezultata razširjenosti in težavnosti bolezni. Cilj statistične analize je bil najti ustrezna multivariantna linearna modela. Rezultati: Oba končna modula sta upoštevala le LDL in starost. Psihološki dejavniki tveganja niso pomembno doprinesli k napovedi razširjenosti in težavnosti koroname arterijske bolezni. Sklepne misli: Na podlagi dobljenih rezultatov smo sklenili, da je potrebno ločevati med klinično enfitefo KB in osnovnim patološkim procesom, to je koronamo aterosklerozo. Vzporedno s tem je potrebno razlikovati tudi med dejavniki tveganja za KB in dejavniki tveganja za razvoj ateroskleroze. Različne razloge lahko naštejemo za odsotnost povezanosti med nekaterimi pomembnimi dejavniki tveganja in razširjenostjo ter težavnostjo bolezni. Glede psiholoških dejavnikov velja izpostaviti večstopenjski razvoj KB z vpletenostio različnih dejavnikov tveganja na različnh stopnjah. Psihološki dejavniki tveganja so najverjetneje vpleteni v akutnem in nenadnem poslabšanju koronamega pretoka zaradi koroname vazokonstrikcije ali celo spazma, kar bi pomenilo, da so lahko pomembnejši v sekundarni kot v primarni prevenciji koronarne bolezni.
Deskriptorji		CORONARY DISEASE CORONARY ARTERIOSCLEROSIS CORONARY ANGIOGRAPHY PERSONALITY TESTS RISK ASSESSMENT CHOLESTEROL LIPOPROTEINS, HDL LIPOPROTEINS, LDL